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Prognostic implications of left ventricular hypertrophy defined by the thresholds from the international and Chinese guidelines

The journal of clinical hypertension (Greenwich, Conn.), 2023-07, Vol.25 (7), p.628-637 [Peer Reviewed Journal]

2023 The Authors. published by Wiley Periodicals LLC. ;2023 The Authors. The Journal of Clinical Hypertension published by Wiley Periodicals LLC. ;2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;ISSN: 1524-6175 ;EISSN: 1751-7176 ;DOI: 10.1111/jch.14687 ;PMID: 37334744

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  • Title:
    Prognostic implications of left ventricular hypertrophy defined by the thresholds from the international and Chinese guidelines
  • Author: Zhou, Dan ; Yan, Mengqi ; Cai, Anping ; Xie, Qiu ; Cheng, Qi ; Tang, Songtao ; Feng, Yingqing
  • Subjects: Age ; all‐cause mortality ; Antihypertensives ; Blood pressure ; Body mass index ; Cardiovascular disease ; Cardiovascular Diseases - etiology ; cardiovascular mortality ; Chinese threshold ; Ejection fraction ; guideline thresholds ; Heart failure ; Humans ; Hypertension ; Hypertension - complications ; Hypertension - epidemiology ; Hypertrophy, Left Ventricular ; Left Ventricular Hypertrophy ; Mortality ; Normal distribution ; Original ; Prognosis ; ROC Curve ; Software ; Stroke
  • Is Part Of: The journal of clinical hypertension (Greenwich, Conn.), 2023-07, Vol.25 (7), p.628-637
  • Description: To compare the predictive value of mortality between left ventricular hypertrophy (LVH) defined by Chinese thresholds and defined by international guidelines in hypertension individuals and investigate better indexation methods for LVH in Chinese population. We included 2454 community hypertensive patients with Left ventricular mass (LVM) and relative wall thickness. LVM was indexed to body surface area (BSA), height2 7 and height 1 7. The outcomes were all‐cause and cardiovascular mortality. Cox proportional hazards models were used to explore the association between LVH and the outcomes. C‐statistics and time‐dependent receiver operating characteristic curve (ROC) was used to evaluate the value of those indicators. During a median follow‐up of 49 months (interquartile range 2–54 months), 174 participants (7.1%) died from any cause (n = 174), with 71 died of cardiovascular disease. LVM/BSA defined by the Chinese thresholds was significantly associated with cardiovascular mortality (HR: 1.63; 95%CI: 1.00‐2.64). LVM/BSA was significantly associated with all‐cause mortality using Chinese thresholds (HR: 1.56; 95%CI: 1.14‐2.14) and using Guideline thresholds (HR: 1.52; 95%CI: 1.08‐2.15). LVM/Height1.7 was significantly associated with all‐cause mortality using Chinese thresholds (HR: 1.60; 95%CI: 1.17‐2.20) and using Guideline thresholds (HR: 1.54; 95%CI: 1.04‐2.27). LVM/Height2.7 was not significantly associated with all‐cause mortality. C‐statistics indicated that LVM/BSA and LVM/Height1.7 by Chinese thresholds had better predictive ability for mortality. Time‐ROC indicated that only LVM/Height1.7 defined by Chinese threshold had incremental value for predicting mortality. We found that in community hypertensive populations, race‐specific thresholds should be used to classify LV hypertrophy related to mortality risk stratification. LVM/BSA and LVM/Height1.7 are acceptable normalization method in Chinese hypertension.
  • Publisher: United States: John Wiley & Sons, Inc
  • Language: English
  • Identifier: ISSN: 1524-6175
    EISSN: 1751-7176
    DOI: 10.1111/jch.14687
    PMID: 37334744
  • Source: MEDLINE
    PubMed Central
    ProQuest Central
    DOAJ Directory of Open Access Journals
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